Provider Demographics
NPI:1396453999
Name:ELITE MINDFUL HEALTH LLC
Entity type:Organization
Organization Name:ELITE MINDFUL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:AURELIEN BUIE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, NP-C, PMHNP-BC
Authorized Official - Phone:561-704-0480
Mailing Address - Street 1:11327 OKEECHOBEE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-8724
Mailing Address - Country:US
Mailing Address - Phone:561-425-9114
Mailing Address - Fax:561-449-2978
Practice Address - Street 1:11327 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-8724
Practice Address - Country:US
Practice Address - Phone:561-425-9114
Practice Address - Fax:561-449-2978
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABVENTURES4LIFE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-11
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105597000Medicaid